Incidence of electrocardiographic changes during cesarean delivery under regional anesthesia.
Serial electrocardiograms were obtained on 93 healthy ASA physical status I and II term parturients during nonemergent cesarean delivery under regional anesthesia. Electrocardiographic changes occurred in 44 of the 93 patients (47.3%); in 35 of these 44 patients, the changes were characteristic, or suggestive, of myocardial ischemia. Symptoms of chest pain, pressure, and dyspnea occurred in 15 of the 44 patients with electrocardiographic changes; no patient without electrocardiographic change developed symptoms of chest pain, pressure, or dyspnea. Small but statistically significant differences were noted in heart rate, diastolic and systolic arterial pressures, and rate-pressure product between the patients with electrocardiographic changes and those without. The authors speculate that myocardial ischemia is a likely cause of both the electrocardiographic changes seen in these patients and of the symptoms of chest pain and dyspnea that they sometimes experience.
Palmer
C M
CM
Department of Anesthesiology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania.
Norris
M C
MC
Giudici
M C
MC
Leighton
B L
BL
DeSimone
C A
CA
D000328:Adult; D000765:Anesthesia, Conduction; D000773:Anesthesia, Obstetrical; D002585:Cesarean Section; D003327:Coronary Disease / Q000503:physiopathology; D004562:Electrocardiography; D005260:Female; D006439:Hemodynamics; D006801:Humans; D010121:Oxytocin / Q000494:pharmacology; D011247:Pregnancy
D010121:Oxytocin